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Analgesia and sedation during placement of peripherally inserted central catheters in neonates
This study aimed to characterize the analgesia and sedation strategies in neonates having a peripherally inserted central catheter (PICC) placed, and to relate it to the number of venepunctures, duration of procedure and catheter tip position. This was a cross-sectional study with prospective data collection, conducted in a neonatal intensive care unit of a private hospital in the city of São Paulo, which evaluated 254 PICC insertions.
The adoption of analgesic or sedative strategies occurred in 88 (34.6%) catheter placements and was not related to the number of venepunctures, duration of procedure or catheter tip position. Intravenous administration of midazolam, in 47 (18.5%), and fentanyl, in 19 (7.3%), catheter insertions were the most frequent strategies. Wider adoption of analgesic strategies is recommended before, during and after the procedure.
Authors : Priscila Costa, Mariana Bueno, Cintia Luiza Oliva, Talita Elci de Castro, Patrícia Ponce de Camargo, Amélia Fumiko Kimura
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Consensus statement for the prevention and management of pain in the newborn.
To develop evidence-based guidelines for preventing or treating neonatal pain and its adverse consequences. Compared with older children and adults, neonates are more sensitive to pain and vulnerable to its long-term effects. Despite the clinical importance of neonatal pain, current medical practices continue to expose infants to repetitive, acute, or prolonged pain.
Experts representing several different countries, professional disciplines, and practice settings used systematic reviews, data synthesis, and open discussion to develop a consensus on clinical practices that were supported by published evidence or were commonly used, the latter based on extrapolation of evidence from older age groups. A practical format was used to describe the analgesic management for specific invasive procedures and for ongoing pain in neonates.
Recognition of the sources of pain and routine assessments of neonatal pain should dictate the avoidance of recurrent painful stimuli and the use of specific environmental, behavioral, and pharmacological interventions. Individualized care plans and analgesic protocols for specific clinical situations, patients, and health care settings can be developed from these guidelines. By clearly outlining areas where evidence is not available, these guidelines may also stimulate further research. To use the recommended therapeutic approaches, clinicians must be familiar with their adverse effects and the potential for drug interactions.Conclusion: Management of pain must be considered an import-ant component of the health care provided to all neonates, regardless of their gestational age or severity of illness.
Authors : From the International Evidence-Based Group for Neonatal Pain
Corresponding author and reprints: K.J.S. Anand, MD, Arkansas Children’s Hospital, 800 Marshall St, Little Rock, AR 72202 – e-mail: anandsunny@exchange.uams.edu
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Epicutaneous-caval catheter placement in newborns 2Fr Nutriline twinflo ( double lumen )
In this video, published by GaVeCelt on their YouTube channel, they show an epicutaneous-caval catheter placement, 2Fr Nutriline twinflo with the micro seldinger technique in the newborn.
You can also find a lot of other interesting information on their website: https://gavecelt.it/nuovo/home -
A review of neonatal peripherally inserted central venous catheters in extremely or very low birthweight infants based on a 3-year clinical practice: Complication incidences and risk factors
The application of peripherally inserted central venous catheters (PICCs) in neonates has proven effective in avoiding repetitive insertions and excessive use of transfusion consumables. However, the frequent occurrence of PICC-associated complications deserves special attention, especially in extremely or very low birthweight (E/VLBW) infants, which in turn affects the quality of neonatal PICC practice.
A total of 519 E/VLBW infants were included in this study. There were 77 cases of complications involving 72 infants with an overall incidence of 12.13%. The order of incidences of different complications from high to low was phlebitis (7.71%), malposition (3.66%), leakage (1.35%), pleural effusion (1.15%), central line-associated bloodstream infection (0.58%, 0.25/1,000d), and accidental removal (0.38%).
E/VLBW infants might be more inclined to develop PICC-associated phlebitis. Catheters inserted in the axillary or basilic vein are preferred if possible.This study is edited by: Fiammetta Piersigilli, Cliniques Universitaires Saint-Luc, Belgium and
reviewed by: Robin Van Der Lee, Radboud University Medical Centre, Netherlands
Advisory board of the NEVATAuthors : Yaohua Wu1,2, Jing Yan1,2, Mengyan Tang3,2*, Yanling Hu1,2, Xingli Wan1,2, Xiaowen Li1,2, Qiong Chen1,2 and Xia Li1,2
1 Department of Neonatology Nursing, West China Second University Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, China,
2 Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China,
3 Department of Child Healthcare Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China -
Epicutaneous-caval catheter placement (from the lower limbs) in the newborn; tip location by ultrasound
In this video, published by GaVeCelt on their YouTube channel, they show an epicutaneous-caval catheter placement (from the lower limbs) in the newborn; tip location by ultrasound.
You can also find a lot of other interesting information on their website: https://gavecelt.it/nuovo/home -
3FR tunneled CICC in neonates
In this video, published by GaVeCelt on their YouTube channel, they show you how to place a tunneled 3FR CICC in a neonate.
You can also find a lot of other interesting information on their website: https://gavecelt.it/nuovo/home -
Securement of central venous catheters by subcutaneously anchored suturless devices in neonates
Accidental dislodgement of central venous catheters is a frequent complication in NICU and it often requires catheter replacement. Subcutaneously anchored sutureless devices (SAS) have been recently introduced in clinical practice for securement of different types of central catheters, but they have never been used in neonates.
In this study they evaluated safety and efficacy of SAS in neonates.Authors : Vito D’Andreaa , Giovanni Baroneb , Lucilla Pezzaa , Giorgia Pronteraa , Giovanni Ventoa and Mauro Pittirutic
a Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy;
b Neonatal Intensive Care Unit, Azienda Sanitaria Romagna, Infermi Hospital Rimini, Rimini, Italy;
c Department of Surgery, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS – Universit!a Cattolica del Sacro Cuore, Rome, ItalyContact : Vito D’Andrea vito.dandrea@policlinicogemelli.it
The journal of maternal-fetal & neonatal medicine
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In Vitro Assessment of Microbial Barrier Properties of Cyanoacrylate Tissue Adhesives and Pressure-Sensitive Adhesives
This study was designed to compare the microbial barrier properties of common pressure-sensitive adhesives to medical-grade cyanoacrylate tissue adhesives (2-octyl cyanoacrylate and N-butyl cyanoacrylate).
No penetration was seen through any of the cyanoacrylate adhesive samples at 72 hours. In sharp contrast, bacteria penetrated 99.3% of the pressure-sensitive adhesive samples at 72 hours.
The authors concluded that medical grade cyanoacrylate tissue adhesives provide a superior microbial barrier compared with common pressure-sensitive adhesives. Consideration could be given to the use of these adhesives for the securement of surgical dressings.Authors : Stephen C Waller 1, David W Anderson 2, Bart J Kane 3, Lisa A Clough 1
1 Division of Infectious Diseases, University of Kansas Health System, Kansas City, Kansas.
2 Kansas City Joint Replacement, HCA Midwest Health, Overland Park, Kansas.
3 Center for Transplantation, University of Kansas Health System, Kansas City, Kansas.
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RaFeVA (Rapid Femoral Vein Assessment)
In this video, published by GaVeCelt on their YouTube channel, they show you how to perform
Rapid Femoral Vein Assessment in neonates.You can also find a lot of other interesting information on their website:
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A Pilot Randomized Controlled Trial of Novel Dressing and Securement Techniques in 101 Pediatric Patients
The purpose of the study was to evaluate feasibility of an efficacy trial comparing peripherally inserted central catheter (PICC) dressing and securement techniques to prevent complications and failure.
The conclusion is that this research suggests safety and acceptability of different securement dressings compared with standard care; securement dressings may also reduce dressing changes after insertion. Further research is required to confirm clinically cost-effective methods to prevent PICC failure.Authors : Tricia M. Kleidon RN, MNursSci a e, Amanda J. Ullman RN, MAppSci, PhD a c, Victoria Gibson BNurs a e, Brett Chaseling MBBS (Hons), FANZCA e f, Jason Schoutrop BSc (Hons), MBBS, FANZCA e f, Gabor Mihala MEng a b d, Claire M. Rickard RN, PhD a c
a Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Brisbane, Queensland, Australia
b Centre for Applied Health Economics, Menzies Health Institute Queensland, Brisbane, Queensland, Australia
c School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
d School of Medicine, Griffith University, Brisbane, Queensland, Australia
e Children’s Health Queensland, Lady Cilento Children’s Hospital, 501 Stanley Street, South Brisbane, Queensland 4101, Australia
f Department of Medicine, University of Queensland, St. Lucia, Queensland, AustraliaJournal of Vascular and Interventional Radiology
